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Yahoo!H.R. 676, the United States National Health Insurance Act, also known as “expanded and improved Medicare for all,” has moved through Congress, and is expected to be signed into law shortly. The legislation provides publicly funded health insurance, with a free choice of health care providers, for every United States citizen and permanent resident.
Doctors operate on a patient who previously would have been denied care.
After the bill passed, Speaker of the House Nancy Pelosi declared, “We can now proudly say that the United States has caught up with the rest of the developed world in granting all our citizens access to high-quality, comprehensive medical care.”
Prior to the bill’s passage, the U.S. health care system was widely regarded to be in a state of severe crisis. Over 46 million Americans have been without health insurance and another 50 million have been under-insured. Despite spending more money per capita on health care than any other nation, the U.S. has lagged behind many countries in such key health-related categories as life expectancy, infant mortality, and preventable deaths. The Institute of Medicine estimates that in recent years approximately 22,000 people have died annually in the U.S. due to a lack of health insurance. Furthermore, nearly one million Americans, many who have private health insurance plans, have filed for bankruptcy each year because they have been unable to pay medical bills. In recent polls, a clear majority of Americans have said they believe government should guarantee health care for all U.S. residents.
Despite growing popular support for a single-payer system, Pelosi acknowledged that Congress would not have voted for this bill without the dedicated grassroots organizing of national groups like Healthcare-NOW and Physicians for a National Health Program, regional groups like the California Nurses Association and the New York-based Private Health Insurance Must Go Coalition, and over 450 union organizations across the country that had endorsed H.R. 676. Pelosi said that many formerly undecided congressional representatives were also swayed by seeing Michael Moore’s film, “Sicko,” and by the cogent arguments presented in a 2008 pocket-sized book, “10 Excellent Reasons for National Health Care,” edited by Mary E. O’Brien and Martha Livingston, that was given to every member of Congress.
Under the private insurance system that has been in place until now, 30 percent of health insurance premiums have gone toward administrative costs, including advertising, profits, and executive salaries. This compares with a 3 percent cost for administering Medicare. Moving from the private health insurance system to single-payer is expected to save $350 billion dollars each year, enough to fund health care for those who are currently uninsured or under-insured. Under H.R. 676, the expanded Medicare for All system will be paid for through a 3.3 percent payroll tax on employers and employees, a stock transfer tax, an income tax surcharge on the top 5 percent of taxpayers, and by reversing the Bush tax cuts on the wealthiest Americans. According to the Congressional Budget Office, most U.S. residents — including those who previously received employer-based coverage–will pay less for this new public health insurance than they did for their private insurance, since there will no longer be any premium, copay, or deductible charges.
Eliminating private insurance companies, including HMOs, and moving to a publicly administered system will be no simple task. The private health-care industry is enormous, employing over 14 million people and costing 2.3 trillion dollars in 2007.
“The transition to a single-payer system will be our biggest challenge for the next 3 years, and a significant struggle even after this bill is signed,” said John Conyers, Democrat of Michigan, who introduced and fought for the legislation. “But with the support of the American people, I have no doubt that we will reach our goal.” In order to make the transition easier for industry workers, H.R. 676 gives former employees of private health insurers first priority for the public-sector jobs that will need to be created to run the new program.
Many Republicans in Congress remain opposed to the new plan, arguing that quality care is best provided by private industry and free markets. Former Speaker of the House Newt Gingrich released a statement saying: “Only market competition can bring choice and lower prices. To see the opposite trend is to be obtuse and shortsighted.” During the House floor debate, some cited claims about long waits for treatment under a similar single-payer system of medical care in Canada; these claims have been discredited by most independent researchers.
The medical services industry is promising to challenge the new bill. In an e-mail to investors, Kaiser chief George Halvorson wrote: “I remain exclusively committed as always to our investors and we plan on using every resource to protect our interests, against which this measure is obviously aimed.” Cigna C.E.O. H. Edward Hanway issued a similar statement: “HMOs have been in business for decades. Now Washington insiders want to take away our profits, our investments, and our property. That is unacceptable, and we will fight tooth and nail to insure our rights under our nation’s Constitution.”
“There has been a long-accepted myth, which is now thankfully receding, that if it’s private, it must be more efficient,” said Secretary of Health and Human Services, former Oregon Governor Dr. John Kitzhaber. “Yet our private, largely for-profit system was bloated, redundant, inefficient, and much more expensive than the better-performing national health care models of many other countries. Plus, many Americans were growing increasingly frustrated with private insurers acting as gatekeepers interfering in doctor-patient decisions, and with receiving denial letters from insurance bureaucrats sitting in cubicles far removed from their medical diagnoses. The single-payer system we will be implementing under H.R. 676 will be a vast improvement over the previous, dysfunctional health care model. And it will pay for itself by eliminating the waste and duplication of the private health insurance industry.”
When reached, a member of the Coordinating Committee of the Private Health Insurance Must Go Coalition noted that the momentum for a single-payer health care system grew after the October 2008 Wall Street bailout: “After the bailout, the American people saw more clearly than ever that our social needs were not always going to be met by private industry or the so-called ‘free market.’ There were no more valid excuses for inaction. If government was able to provide a safety net to Wall Street, it was capable of providing the American people with some real health-care security. After all, it’s not only the financial industry that has been affected by the economic downturn. It’s about time that the U.S. has joined the rest of the planet in recognizing that health care access is both a necessity and a human right. During these difficult times, a single-payer system should help to ease the financial strain that people are feeling and might even help stimulate the overall economy.”
Unlike the response from company executives, reaction to the passage of H.R. 676 among insurance industry employees has been largely positive. Sarah Schwartz, a Cigna medical records specialist in Ohio, said: “I’ll get retraining. They need people who do what I do. I’ll get different forms and procedures, that’s all. Plus this new system will be much better for the patients, so that feels good.” When asked about other changes the new law will bring, Schwartz told the Times about her aging mother who, at 71, continues to work at a full-time office job. “She almost got laid off last year, which meant my dad wouldn’t have been able to see a doctor for his heart problems anymore, since he was covered under her plan. For our family, this bill passed just in time.”
“Health care should be like water — a right for everyone. Anything less is barbaric,” said a spokesperson for Physicians for a National Health Program, an organization that has advocated for health care reform since 1987.
In recent years, a majority of physicians had grown tired of the growing, confusing, and sometimes disruptive role of the private insurance companies, with a 2008 poll showing 59 percent of doctors supporting a single-payer system. At an American Medical Association banquet last night, a spontaneous standing ovation occurred when doctors learned of the bill’s success. A.M.A. President Nancy Nielsen, M.D. said in her speech: “We’re trained to save lives. We’re trained to practice medicine. Finally, we can do what we entered this field to do — practice with the interest of patients at heart.”
[...] This morning, New Yorkers were gifted with free copies of the NY Times on the street - but they weren’t just any New York Times. They were copies from the future, dated July 4, 2009, and headlined with the long-awaited news: “IRAQ WAR OVER.” The copies, bearing the same look and feel as the real deal, are filled with other fake news stories pointing to the pranksters’ hopes of what the future could hold (i.e., “New York Bike Path System Expanded Dramatically” and “National Health Insurance Act Passes.”) [...]
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